Provider Demographics
NPI:1992743322
Name:HORNE, HARRY (DO)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:HORNE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 514
Mailing Address - Street 2:
Mailing Address - City:GAINESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38562-0514
Mailing Address - Country:US
Mailing Address - Phone:931-243-5259
Mailing Address - Fax:931-243-5156
Practice Address - Street 1:151 MCARTHUR AVE
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551-4003
Practice Address - Country:US
Practice Address - Phone:931-243-5259
Practice Address - Fax:931-243-5156
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN847207P00000X
TNDO0000000847207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3319424Medicaid
KY6491039100Medicaid
AL890-26129OtherBCBS
AL009941709Medicaid
TN4072314OtherBCBS OF TN
TNP00231037OtherRAILROAD MEDICARE
AL009941709Medicaid
KY6491039100Medicaid